Objective: To investigate the value of plasma NT-proBNP level for the diagnosis of heart failure with normal ejection fraction(HFNEF).Methods:Plasma NT-proBNP concentrations were mearsured by ELISA method in the 88 patients with essential hypertension and normal left ventrcular ejection fraction(LVEF) and 20 healthy subjects.The relationship of plasma NT-proBNP level with the severity of diastolic dysfunction and NYHA classification was analysed.The ROC curve of plasma NT-proBNP level for diagnosis of HFNEF was established and a optimal cuff-off threshold was obtained.Results:Plasma NT-proBNP level was correlated with the severity of diastolic dysfunction and NYHA classification,and was increased with the increase of diatolic dysfunction grade and NYHA class.The sensitivity,specificity,positive predictive value and negative predictive value of plasma NT-proBNP level for diagnosis of HFNEF were 90.5%,97%,95% and 94.1% respectively when the cut-off threshold was 286pg/ml.Conclusion: Plasmal NT-proBNP level is an important biomarker for the diagnosis of HFNEF.
To explore the prevalence and risk factors for the onset of heart failure after right ventricular apical pacing.The clinical data of 1 343 patients with pacemaker implantation at our hospital from 2003 to 2008 were analyzed retrospectively. And the predictors of heart failure were evaluated by the Cox proportional hazard model and Kaplan-Meier method.During a median follow-up period of 71 (76±24) months, 303 patients (22.6%) developed a new onset of heart failure. Multivariate Cox analysis revealed that ≥65 years old (hazard ratio 2.37), a history of myocardial infarction (hazard ratio 2.16), VVI mode (hazard ratio 2.37), left ventricular ejection fraction (LVEF)<50% (hazard ratio 2.00), atrioventricular block or atrial fibrillation with slow ventricular rate etiologically (hazard ratio 1.43) were independent risk factors for heart failure (P<0.05). And the risks increased by 19.4%, 33.0%, 20.9%, 38.4%, 17.2% or 25.9% at 71 months respectively.After right ventricular apical pacing, heart failure is a progressive syndrome correlated with basal cardiac functions, underlying etiologies and age. And right ventricular apical pacing should be avoided in patients with high risk factors.
Cardiac Purkinje cells are important triggers of ventricular arrhythmias associated with heritable and acquired syndromes; however, the mechanisms responsible for this proarrhythmic behavior are incompletely understood. Here, through transcriptional profiling of genetically labeled cardiomyocytes, we identified expression of Purkinje cell protein-4 (Pcp4), a putative regulator of calmodulin and Ca2+/calmodulin-dependent kinase II (CaMKII) signaling, exclusively within the His-Purkinje network. Using Pcp4-null mice and acquired cardiomyopathy models, we determined that reduced expression of PCP4 is associated with CaMKII activation, abnormal electrophysiology, dysregulated intracellular calcium handling, and proarrhythmic behavior in isolated Purkinje cells. Pcp4-null mice also displayed profound autonomic dysregulation and arrhythmic behavior in vivo. Together, these results demonstrate that PCP4 regulates cardiac excitability through both Purkinje cell-autonomous and central mechanisms and identify this modulator of CaMKII signaling as a potential arrhythmia-susceptibility candidate.
AbstractObjective To analyze the clinical characteristics of neonatal cases of severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection in Suzhou since December 2022. Methods In this retrospective case series study, the clinical data of 23 neonates with SARS-CoV-2 infection at our hospital from December 10, 2022, to January 10, 2023, were collected, and the epidemiological history, clinical manifestations and outcomes, laboratory changes, etc., were analyzed. Results Among the 23 infants, there were 9 males and 14 females, 22 full-term infants, and 1 premature infant (35 weeks+ 1). The oldest was 27 days old, and the youngest was premature. Age at diagnosis was 14(9.0,19.0) days. The mothers were all prenatally diagnosed with coronavirus disease 2019 (COVID-19). All 22 full-term infants lived with their mothers in the same room. Among them, 8 were exclusively breastfed, 14 were mixed-fed, and 1 was a preterm infant who was not breastfed. Twenty-two neonates were infected by horizontal transmission, and 1 was infected by suspected vertical transmission from mother to child. The clinical classification included 1 asymptomatic infection, 20 mild infections, 2 moderate infections. The most common clinical manifestations were fever (21 neonates), and the fever duration was 1–6 days. Other clinical manifestations included respiratory symptoms(18 neonates), digestive tract symptoms(12 neonates) and abdominal distension (2 neonates). Neurological symptoms included mild drowsiness, irritability, and crying (3 neonates). The other symptoms included 4 cases of jaundice and 2 cases of rash. The white blood cell count was lower than 4.0*109/L in 1 neonate. The lymphocyte count was lower than 1.0*109/L in 1 neonate. Interleukin-6 was normal in 3 neonates, slightly elevated in 11 neonates, and greater than 200 pg/ml in 2 neonates. Procalcitonin was slightly elevated in 1 neonate. The creatine phosphokinase isoenzyme (CK-MB) was slightly elevated in 4 neonates. Two neonates had flocculent high-density shadows in chest X-ray. 21 patients were cured and discharged, while another 2 patients were discharged after improvement; the length of hospitalization was 3.8 (4.0,5.0)days. Twenty-one patients were followed up and no repeated clinical manifestations were reported. Conclusion SARS-CoV-2 infection in neonates in this area was mainly transmitted horizontally and mainly mild cases, with mild clinical symptoms and mildly increased inflammatory indicators. The short-term prognosis was good.
Objective To investigate on epidemic factors of coal-burning endemic fluorosis areas in Chongqing and provide a scientific basis for control strategies.Method Dental fluorosis among children and prevention of fluorosis status were analyze through sampling and monitoring of coal,soil,air,water,food,vegetables,tea etc.Coal-burning fluorosis endemic factors and the control strategies were analyzed.Result 86509 children aged from 8～12 in 666 fluorosis regions were investigated.The detection rate of dental fluorosis is 51.05% and defect rate is 4.30%,with the index of 0.83.The fluorine content in coal,mixed coal-soil,soil mixed coal and soil were 310.56 mg / kg,360.51 mg / kg,293.62 mg / kg,497.54 mg / kg,respectively,are significantly higher than non-endemic area(48.68 mg / kg,275.66 mg / kg,150.20 mg / kg,269.98 mg / kg,respectively).There is no significantly difference in fluorine content between Fluoride cinder Ward(209.14 mg / kg)and non-endemic area(186.59 mg / kg).Fluorine content in water and endemic fluorosis pepper(0.30 mg / L,25.50 mg / kg)were significantly higher than those in non-endemic area(0.18mg / L,2.83 mg / kg).The fluorine contents in rice,potatoes and vegetables in endemic area(1.31 mg / kg,0.64 mg / kg,1.10 mg / kg) were significantly higher than those in non-endemic area(0.77 mg / kg,0.44 mg / kg,0.48 mg / kg).The fluorine content of the indoor air of 3 heavy,moderate fluorosis endemic villages(13.56,14.68 μg / m3)was significantly higher than that of the non-endemic area(1.00,0.31μg / m3).The fluoride intake of the residents in endemic areas via tea drinking(2.45 mg / person) was significantly higher than that innon-endemic area(1.80 mg / person).In the endemic areas,the consumption rate of rice was 100 percent,with annual per capita consumption of 77.68 kg;corn consumption rate was 54.63%,with annual per capita consumption of 17.79 kg.The stove pass correct utilization rate was 53.44%.Conclusion The main epidemic factors of coal-burning fluorosis in Chongqing is the fluoride which was released from high fluoride coal in cooking and heating.Fluorosis is manily caused by inhaling fluoride through respiratory tract.Whether there are other factors like tea drinking needs to be further studied.Correct usage stoves is still main prevention and control measures of coal-burning fluorosis.
[Abstract] Objective To understand the damage to the cardiovascular systems of patients with different degrees of skeletal fluorosis after stopping fluorine exposure. Methods 65 patients with mild, moderate and severe skeletal fluorosis and 23 subjects without skeletal fluorosis as the control group were selected for detailed inquiry of cardiovascular disease history, blood pressure measurement and ECG examination. Results The rate of skeletal fluorosis patients with cardiovascular system symptoms accounted for 70.77%, and the difference was statistically significant as compared with that of the control group (P 0.05). [As seen from] the comparison of ECG parameters, the P-R intervals of the severe skeletal fluorosis group were significantly prolonged and statistically different as compared with those of the control group (P 0.05). Conclusion The normal physiological functions of cardiovascular systems of skeletal fluorosis patients are still subject to a certain level of interference after 18 years of water quality improvement and fluoride reduction. The abnormal ECG changes can be significantly recovered in mild and moderate skeletal fluorosis patients, but in severe skeletal fluorosis patients, the recovery speed may be very slow. The long-term effects of severe skeletal fluorosis on the changes in patients’ ECGs remain to be further investigated.
Obesity is an independent risk factor for cardiovascular disease development. Here, we aimed to examine and compare the predictive values of three novel obesity indices, lipid accumulation product (LAP), visceral adiposity index (VAI), and triglyceride-glucose (TyG) index, for cardiovascular subclinical organ damage.A total of 1,773 healthy individuals from the Hanzhong Adolescent Hypertension Study cohort were enrolled. Anthropometric, biochemical, urinary albumin-to-creatinine ratio (uACR), brachial-ankle pulse wave velocity (baPWV), and Cornell voltage-duration product data were collected. Furthermore, the potential risk factors for subclinical organ damage were investigated, with particular emphasis on examining the predictive value of the LAP, VAI, and TyG index for detecting subclinical organ damage.LAP, VAI, and TyG index exhibited a significant positive association with baPWV and uACR. However, only LAP and VAI were found to have a positive correlation with Cornell product. While the three indices did not show an association with electrocardiographic left ventricular hypertrophy, higher values of LAP and TyG index were significantly associated with an increased risk of arterial stiffness and albuminuria. Furthermore, after dividing the population into quartiles, the fourth quartiles of LAP and TyG index showed a significant association with arterial stiffness and albuminuria when compared with the first quartiles, in both unadjusted and fully adjusted models. Additionally, the concordance index (C-index) values for LAP, VAI, and TyG index were reasonably high for arterial stiffness (0.856, 0.856, and 0.857, respectively) and albuminuria (0.739, 0.737, and 0.746, respectively). Lastly, the analyses of continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) demonstrated that the TyG index exhibited significantly higher predictive values for arterial stiffness and albuminuria compared with LAP and VAI.LAP, VAI, and, especially, TyG index demonstrated utility in screening cardiovascular subclinical organ damage among Chinese adults in this community-based sample. These indices have the potential to function as markers for early detection of cardiovascular disease in otherwise healthy individuals.
Aims: To investigate the association between triglyceride–glucose(TyG) index and the risk of hypertension. Method: A cross-sectional study was conducted in Bengbu, China. The participants received relevant questionnaire survey, anthropometric tests, and laboratory examination. Multivariate logistic regression analysis was performed to estimate the possible association between TyG index and hypertension risk. The additive interaction evaluated by the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index(SI) was calculated. Results: A total of 1777 participants (748 men and 1029 women) were investigated. There was a significant increase in the risk of hypertension and isolated systolic hypertension (ISH) when comparing the highest TyG index (the fourth quartile) to the lowest TyG index (the first quartile) and corresponding ORs were 2.446 (95% CI: 1.746–3.426) and 2.621(95%CI: 1.627–4.224), respectively. However, no significant relationship was observed between TyG index and isolated diastolic hypertension (IDH). In males, significant interactions between TyG index and WHtR (RERI:1.978, 95%CI: 0.162–3.792; AP: 0.359, 0.113–0.605; SI:1.782, 1.017–3.122), smoking (AP: 0.437, 95%CI: 0.048–0.825), family history of hypertension (AP:0.433, 95%CI: 0.203–0.662; SI:2.248, 95%CI: 1.333–3.791) were observed. As for females, there were also significant interactions between TyG index and WHtR (RERI:1.415, 95%CI: 0.693–2.136; AP: 0.198, 95%CI: 0.104–0.291; SI:1.298, 95%CI:1.101–1.530), family history of hypertension (RERI:1.744, 95%CI: 0.221–3.267; AP:0.405, 95%CI: 0.113–0.697) on risk of hypertension. Conclusions: Increased TyG index was significantly associated with higher risk of hypertension and ISH, but not for IDH in middle-aged and elderly adults. Our results also demonstrated interactions of TyG index and abdominal obesity and family history of hypertension on hypertension risk.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)